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How To Use An Ophthalmoscope Terkunci

The document provides instructions for using an ophthalmoscope. It describes how the direct ophthalmoscope contains lenses that can be rotated into the viewing aperture, with positive lenses bringing the focus closer and negative lenses taking it further. It explains how distant direct ophthalmoscopy from 20-40cm allows screening for opacities, appearing in dark silhouette. Close direct ophthalmoscopy within 3-5cm typically brings the optic disc into focus at lens 0, examining over 50% of the fundus with dilation. Rotating higher positive lenses brings the focus closer to examine specific structures like the vitreous, lens, and anterior chamber.

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Mukhlisa Rahman
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143 views2 pages

How To Use An Ophthalmoscope Terkunci

The document provides instructions for using an ophthalmoscope. It describes how the direct ophthalmoscope contains lenses that can be rotated into the viewing aperture, with positive lenses bringing the focus closer and negative lenses taking it further. It explains how distant direct ophthalmoscopy from 20-40cm allows screening for opacities, appearing in dark silhouette. Close direct ophthalmoscopy within 3-5cm typically brings the optic disc into focus at lens 0, examining over 50% of the fundus with dilation. Rotating higher positive lenses brings the focus closer to examine specific structures like the vitreous, lens, and anterior chamber.

Uploaded by

Mukhlisa Rahman
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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How to use an Ophthalmoscope

Andy Matthews BVM&S (Dist), PhD, DipECEIM, Hon MACVO, FRCVS


European Specialist in Equine Internal Medicine
Ayrshire, Scotland

Basic use of a Direct Ophthalmoscope


 All direct ophthalmoscopes house a carousel containing up to 20
lenses. Each lens can be rotated into the viewing aperture (Fig 1). 1
 The ‘positive’ lenses (typically with black dioptre indicators 1-10) are
increasingly convex. Hence the higher number lenses bring the focus
closer to the operators eye. 3
 The ‘negative’ lenses (typically with red dioptre indicator 1-10) are
increasingly concave. Hence the higher numbers take the focus point
further from the operator’s eye.
2
 At 0, the carousel is empty or contains plain glass.

Fig 1: The Direct Ophthalmoscope. The operator side showing the viewing
aperture (1), the lens indicator (2) and the rotating carousel housing the lenses (3)

Distant Direct Ophthalmoscope

 This is a first line technique and is used to


screen for the presence of opacities or
refraction anomalies in the transparent media
of the eye, particularly the cornea and lens.
 Ideally in a darkened area, select the ‘0’ lens
and examine the eye from 20-40cm distance.
 Opacities in the transparent media will appear in
dark silhouette against the tapetal reflex. This is
called ‘retroillumination’ (Fig 2).
 Anyopacitiy can be further examined by close
direct opthalmoscopy or direct illumination.

Fig 2: Linear opacity in the lens viewed by


Distant Direct Ophthalmoscopy.
Close Direct Ophthalmoscopy

 For the operator with normal refraction and the instrument held 3-5cm from the horse’s eye, at
0 the optic disc can typically be brought into sharp focus (Fig 3). This will vary with the refraction
of the operator’s eye and with the viewing distance selected.
 The fundic image is upright and magnified (Fig 2). With the pupil fully dilated (using tropicamide
NOT atropine) >50-60% of the fundus can be examined.
 To examine the vitreous. Lens and anterior chamber,
the ‘positive’ lenses are progressively rotated into the
viewing aperture bringing the focus closer to the
operators’s eye. This is usually combined with
slight alterations in the focal distance (the horse or
Fig 3: Normal optic disc viewed by
operator moving their head back and forward, often Close Direct Ophthalmoscopy.
inadvertently) until the anatomic feature is in focus.
 For me, with near normal refraction, the vitreous is
examined at +2-5, the posterior lens at +5-6 and the
anterior lens at + 6-7.

Fig 3: Normal optic disc viewed by


Close Direct Ophthalmoscopy.

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